SPATIAL HETEROGENEITY OF NEIGHBORHOOD-LEVEL WATER AND SANITATION ACCESS IN INFORMAL URBAN SETTLEMENTS: A CROSS-SECTIONAL CASE STUDY IN BEIRA, MOZAMBIQUE

Rapid urbanization, resulting in population growth within informal settlements, has worsened exclusion and inequality in access to water and sanitation (WASH) services in the poorest and most marginalized communities. In this study, we describe the heterogeneity in water service satisfaction and WASH access in low-income, peri-urban neighborhoods of Beira, Mozambique, and examine whether this heterogeneity can be explained by distance to water distribution mains. Using spatial statistics and regression analyses, we identified statistical spatial heterogeneity in household WASH access, as well as consumer-reported satisfaction with water services (services, pressure, quality, and sufficient quantity). We found that as distance from the water main increased, both access to an improved water source at the household and satisfaction with water pressure decreased, controlling for household density and socioeconomic status. The odds of a household having access to a water source at the household or on the compound decreased with every 100-meter increase in distance from a water main pipe (odds ratio [OR] 0.87, 95% confidence interval [CI]: 0.82, 0.92). Satisfaction with water services also decreased with every 100-meter increase in distance from a water main pipe (OR: 0.80; 95% CI: 0.69, 0.94). Findings from this study highlight the unequal household access to water and sanitation in urban informal settlements, even within low-income neighborhoods. Describing this heterogeneity of access to water services, sanitation, and satisfaction – and the factors influencing them - can inform stakeholders and guide the development of infrastructural solutions to reduce water access inequities within urban settings.